Parma Community General Hospital received top ratings in surgery outcomes in a newly released Consumer Reports analysis.Plain Dealer

CLEVELAND, Ohio -- Two Northeast Ohio hospitals – Parma Community General Hospital and Southwest General Health Center – earned the highest overall ratings in Consumer Reports’ evaluation of how patients fare during and after surgery.

This is the first time the consumer magazine has looked at surgical outcomes which combined results of 27 categories of scheduled surgeries as well as individual ratings in five categories – back surgery, hip replacement, knee replacement, angioplasty and carotid artery surgery.

The ratings, released today, were done on a five point scale ranging from better to worse.

Of the 20 hospitals in Greater Cleveland, five hospitals earned the second-highest rating including Euclid Hospital in Euclid, Marymount Hospital in Garfield Heights, Medina Hospital in Medina, and St. John Medical Center in Westlake.

Hillcrest Hospital in Mayfield Heights, earned the lowest surgery rating on the scale. Lutheran Hospital as well as St. Vincent Charity Medical Center and Akron General Medical Center earned the second-lowest rating.

“It’s good for people to know that community hospitals are doing highly commendable work,” said Dr. Dale Cowan, vice president of medical affairs at Parma Community hospital. He attributed the hospital’s good rating to teamwork among the medical staff and attention to detail.

In addition, three hospitals earned the highest rating for knee replacement surgery: Parma Community, Southwest General and University Hospitals Case Medical Center in Cleveland.

Dr. Matthew Joseph Kraay, director of joint reconstruction and arthritis surgery at UH, said the medical center has for years focused on quality. “We are dedicated to a process of continued improvement by willingly assessing outcomes and focusing on innovations.”

Consumer Reports said that up to 30 percent of hospital patients suffer from infections, heart attacks, strokes and other complications after surgery.

But consumers have very little to go on when selecting a hospital because it’s not clear which hospitals are doing the best job, said Doris Peter, associate director of Consumer Reports’ Health Ratings Center.

The surgery ratings by Consumer Reports were based on an analysis of billing claims that hospitals submitted to Medicare for patients 65 and older from 2009 to 2011. The data covered 2,463 U.S. hospitals. The ratings were based on the percentage of a hospital’s Medicare patients who died in the hospital or stayed longer than expected for their procedure.

Peter explained that research shows that mortality and length of stay correlate with complications. Some medical centers use these numbers to monitor quality. Consumer Reports worked with the health consulting firm MPA to analyze billing claims and clinical records data.

But some health care officials took issue with the type of data used to develop the ratings.

Dr. Michael Henderson, chief quality officer at the Cleveland Clinic said that the data used by Consumer Reports were based on codes used for billing claims of procedures performed in the hospitals rather than clinical data from patient records.

“It’s interesting and important, but I think in fairness to patients, we have to point out the shortcomings of the kind of data collected,” Henderson said. “You can still have complications after being released from the hospital.”

This data only covered the time a patient was in the hospital and not follow-up home care or readmissions.

A study by the American College of Surgeons suggests that most surgical complications occur seven to 14 days after surgery, when many patients have been released from the hospital.

Henderson pointed out that the Clinic readily shares its surgical outcome data on its website.

Kraay said he also questioned the methodology. Some of the other organizations that rate hospitals have quality assessments and risk adjustments built into their ratings systems for a more accurate comparison between larger hospitals that typically perform a greater number of the most complex cases compared to smaller community hospitals.

Consumer Reports’ Peter said that the Medicare claims data was not “perfect” but still gives a “slice of what happens to surgical patients in hospitals.”

The ratings can be useful to patients planning to have surgical procedures in combination with other ratings such as LeapFrog, Hospital Compare, individual hospital websites and more, she said.

She urged people to also ask their surgeons for performance data. “Some people think the doctors won’t respond. But if they know the data, they’ll tell you what it is. You have to ask the question.”

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